Provider Demographics
NPI:1922656628
Name:DE BRUIN, KAREN (CSW-PIP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:DE BRUIN
Suffix:
Gender:F
Credentials:CSW-PIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7520 S GRAND ARBOR CT STE 136
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-3456
Mailing Address - Country:US
Mailing Address - Phone:605-205-7572
Mailing Address - Fax:
Practice Address - Street 1:7520 S GRAND ARBOR CT STE 136
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-3456
Practice Address - Country:US
Practice Address - Phone:605-205-7572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-27
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD62591041C0700X
SD4959104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker